Abstract
The psychiatric aspects of David Hartley’s writings have received less attention than the rest of his work. This Classic Text deals with Section VI of his Observations on Man …, namely, the ‘Imperfections of the rational Faculty’. Hartley defines madness as an imperfection of reason that can be temporary or enduring. He makes use of his model of mental functioning to differentiate between eight clinical categories of madness, each representing a different pattern of vibrations of the nerves. Hartley developed this model based on Newton’s theory of vibrations and, to explain the complexity of mental acts and entities, he combined it with his own version of the mechanism of Association of Ideas borrowed from John Locke. Much work needs to be done to identify the provenance of Hartley’s nosology and nosography.
Keywords
Introduction
Scholarship on David Hartley’s writings (Allen, 1999), particularly on his Observations on Man … 1 (Oldfield and Oldfield, 1951; Webb, 1988), is vast. This book touches upon themes currently pertaining to Theology, Ethics, Human Sciences, Literature, Philosophy, Psychology and Psychiatry (Delkeskamp, 1977; Hayden, 1984; Heider, 1913; Leslie, 1972; Marsch, 1959; Nuovo, 1999; Walls, 1982) and hence it is not surprising that it features in the history of all these disciplines. This notwithstanding, some themes, e.g. Hartley’s views on mental disorder, have received less scholarly attention. The Classic Text below is concerned with Section VI of Observations … where Hartley applies his model of the functioning of the mind to mental afflictions (‘Imperfections of the rational Faculty’).
The son of a clergyman, David Hartley was born in Yorkshire circa 1705 and died in 1757. Educated at Bradford and then at Jesus College, Cambridge, he is known to have refused to sign the Thirty-Nine Articles (Allen, 2008; Young, 1972). After working as a schoolteacher he took up the practice of medicine, although there is no evidence that he ever graduated MD (Webb, 1989). He practised in Bury St Edmunds and in London, and his clinical interests ranged from recommending inoculation to developing ‘lithontriptic’ substances. In this regard he wrote a defence of Mrs Stephens’ medicine, assumedly efficacious in the dissolution of kidney stones (Hartley, 1739; Viseltear, 1968).
According to the received view, Hartley was one of the first to introduce a viable model for a ‘Physiological Psychology’, that is, an account of the mind reducible to a mechanistic, non-vitalistic neurophysiology (Berington, 1776; Bower, 1881; Priestley, 1775). He explained nerve functioning and conduction in terms of micro-vibrations (vibratiuncles), thereby extending to the nerves and brain Newton’s view on the role that ‘vibrations’ in general might play in the transmission of information in Nature (Smith, 1987; Wade, 2005). To account for complex mental functions, Hartley made use of Association of Ideas, an abstract mechanism that John Locke, inter alia (Kallich, 1945), had introduced into his philosophical psychology to explain how simple ideas could be put together in complex, lasting clusters of ideas (Buckingham and Finger 2009; Oberg, 1970). Perception, memory, learning and intellect in general could be explained as consisting of processes that allowed information to become integrated into associative clusters (D’Elia, 1970; Glassman and Buckingham, 2007; Oberg, 1970).
Views on the ideas expressed in Hartley’s Observations … have changed over the years. Contemporaries were both sympathetic (Priestley, 1775) and critical (Berington, 1776). The Scottish Philosophers of Common Sense disagreed in toto (e.g. MackIntosh, 1836; Reid 1785) while Hazlitt (1805), Coleridge and J.S. Mill rejected only aspects of Hartley’s model (Young, 1970). Well into the nineteenth century, Bain (Dupont, 2007) and Spencer (Young, 1972) also made use of his ideas.
Hartley’s place in the history of British ideas has continued to be reassessed (Allen, 1999). His vibrations model was never fully accepted or used in empirical research, either because it was misinterpreted and ridiculed (for example, Boerhaave seems to have believed that Hartley was claiming that nerves vibrated like strings – and hence found it easy to counteract his view; Glassman and Buckingham, 2007) or because it was replaced by the electricity model of neural transmission (Ochs, 2004; Smith et al., 2012).
His position within Associationism has also been revised. The earlier, rather generic interpretations of this psychological doctrine (Claparède, 1903; Warren, 1921) gave way after World War II to more detailed explorations (Kallich, 1970; Rapaport, 1974), culminating in a new way of mapping the Associationistic models of Locke, Hartley, Condillac, Bonnet, Hume, etc. (see, e.g. Bricke, 1974; Buckingham and Finger 2009; Drever, 1965; Hoeldtke, 1967).
Madness in 18th century Britain
The social and institutional history of madness in eighteenth-century Britain (Andrews and Scull, 2001, 2003; Ingram, 1991; Laffey, 2001, 2002/2003, 2003; Leigh, 1961; Parry-Jones, 1972; Porter, 1983, 1987; Smith, 1992, 2007) has been better served by historians than the history of its epistemology, aetiology and taxonomy. 2 Much as studying the latter may be cumbersome or less fashionable, it remains a fact that any social, political and institutional frame constructed to explain the narratives of madness has to be anchored on detailed nosographic information. An absence of such scholarship, particularly in the British context of the eighteenth century, may explain why Section VI of Observations … has been less commented upon than the rest of Hartley’s work.
In Classic Text No. 101, Hartley first offers a definition and a classification of madness and then applies his vibrations model to each of the eight types of madness listed. Both his definition and classification are idiosyncratic in that they do not obviously correspond to contemporary views on madness. He used madness as a generic term for all ‘imperfections of the rational faculty’ and also as a specific diagnosis. There are eight ‘imperfections’: 1. Erroneousness of judgement in children and idiots; 2. Dotage in the elderly; 3. Drunkenness; 4. Delirium in acute distempers; 5. Recurrence of the same ideas in the course of study; 6. Violent passions; 7. Melancholy; and 8. Madness.
As expected, none of these clinical categories specifically correspond to any current one. The ones that are least clinically recognizable are 1, 5 and 6. All eight are presented as either resulting from or being characterized by a failure of the ‘rational faculty’ and seem to result from different aetiologies. The term ‘Madness’ in Hartley’s broad sense can be applied to all the categories, including those in which the subjects are said to be of ‘sound mind’. Hence, together with type and degree, duration (temporary or long-term) of madness is an important classificatory criterion. Equally interesting is Hartley’s claim that no clear demarcation line can be drawn between soundness and unsoundness of mind.
Hartley wishes to show that different patterns of vibration may explain the ontological and behavioural differences that exist between all eight categories. Patterns of vibration, however, play an ambiguous causal role. In a sense they are proximal causes, in the sense that physiopathological patterns vary from disease to disease but they are not distal causes, that is, explanations for why nerves can be affected by different patterns of vibration.
What during the eighteenth century was conventionally called ‘Madness’ is discussed by Hartley under: Melancholy (which includes Hypochondria, Hysteria, and Vapours, and has little to do with the current concept of Melancholia) and Madness proper. Indeed, given time and other (unknown) factors, Melancholy can become Madness. The sources of Hartley’s nosology are unclear. British medics interested in Madness at the time of Hartley, such as Cheyne (Viets, 1949), Monro (Andrews and Scull, 2001), Battie (Suzuki, 2004), Whytt (Carmichael, 1927; French, 1969), and James (Berrios, 2013; Stine, 1941), used different classifications. There is little evidence that Hartley was au fait with Continental nosology. 3
Hartley’s belief that madness was an impairment of intellect, a failure in the processing of information rather than in the information itself is, of course, Lockean in origin (Berrios, 1996). Madness could be brought about by bodily or mental causes. Mental causes could be hereditary (a sort of predisposition) and they become ‘actual’ only when ‘some bodily distemper gives it full scope to exert itself’. Much work needs to be done to understand Section VI. However, we can all agree with Hartley’s plea that: ‘An accurate history of the several kinds of madness from those physicians, who are much conversant with this distemper, is greatly wanted …’